by Dean Backes
Special to The Leaven
KANSAS CITY, Kan. — Each fall, television viewers across the country are inundated with celebrities championing Medicare hotlines that sometime provide extra benefits to retirees and some individuals with disabilities.
That’s because Medicare Open Enrollment — also known as Medicare’s annual election period — runs from Oct. 15 through Dec. 7 each year.
Be warned, however, that failing to do timely research and not sitting down with an expert may cost Medicare recipients in the long run.
“I am a big proponent of ‘don’t go it alone,’” said Robert Falke of the Robert E. Miller Group, which assists the Archdiocese of Kansas City in Kansas in this area. “Make sure that you get somebody that’s going to help you. The 800 numbers they have on television are fine. There is nothing necessarily wrong with them. But I would prefer to have somebody that I can sit down with and have that discussion that can help me make an informed decision.”
Maura Dodson, a benefits specialist for the archdiocese, described Medicare as the one major decision that American seniors will make just once in their lifetime.
“It’s difficult to navigate buying a house,” Dodson said. “But maybe I get to do that again. And do it better the next time. You only get to do this once. And it’s tough.”
Although open enrollment began in mid-October and runs through Dec. 7 this year, Falke said retirees should begin the research process long before the deadline. Once an individual reaches 63 years of age, Falke suggests they start looking at their options, thanks in large part to the confusion and all of the timelines associated with the process.
Because his organization deals with Medicare and other benefits, the Miller Group, which also works with the Diocese of Kansas City-St. Joseph in Missouri, sometimes engages professional Medicare specialists to assist their clients.
“These consultants are local, and they work with the employer or the individual,” Falke said of consultants like Medicare Done Professionally (MDP). “They walk people through all of the different plans. You have your Medicare replacement programs, you have Medicare supplement programs, you have Medicare Part D and all of this good stuff. It’s important that you have somebody that you’re working with that you trust.”
According to MDP’s website, Medicare has four main parts: Medicare Part A (hospital insurance); Medicare Part B (medical insurance); Medicare Part C, which is another way to get Medicare Part A and Medicare Part B; and Medicare Part D (prescription drug plan). Then, once a Medicare seeker starts looking into Medicare supplements, the retiree tackles the headaches associated with Medicare Parts F, G, K, L, M and N.
More confusing still is the range of Medicare Advantage plans that should also be considered. They offer another way to get Medicare Part A and B coverage but through a private-sector health insurer, and there are a lot to choose from.
Employees of the Archdiocese of Kansas City in Kansas can reach out to Falke at (816) 308-4580 or give Dodson a call at (913) 647-0362. Dodson said if Medicare seekers come to her, she usually points them in the direction of Senior Health Insurance Counselors for Kansas (SHICK).
SHICK is a free program that connects Kansans with trained volunteers to get answers to questions they might have about Medicare. SHICK counselors are located throughout the state of Kansas and are trained on Medicare, Medicare supplement insurance, long-term care and other health care concerns that Kansas seniors and persons with disabilities might have.
“I’ve been hearing great things about the SHICK program,” Dodson said. “I’ve had a couple of people come back and say that it is exactly what they needed. They’re trained community volunteers. They’re not getting paid for this.
“I suggest people go to SHICK. But then, I always say, ‘Whoever you have an insurance relationship with, go and see what kind of supplements they have.’”
According to Dodson, retirees cannot supplement their employer’s plan with Medicare. For seniors that have health insurance through their employer, or their spouse’s employer, it’s always primary with some exceptions.
Before making any changes, therefore, employees are advised to carefully compare their employer’s plan with what Medicare provides. If a person continues to work past 65, he or she will need to do the math to discover whether it is cheaper to switch to Medicare or to stay on their employer’s plan.
Moreover, at least at this time, Medicare only covers health expenses — not vision, hearing or dental expenses. Some Medicare Advantage plans cover some but not all of these services, so it pays to compare and contrast.
Persons with disabilities should start looking into Medicare immediately, while seniors approaching 65 can register with the Medicare system through Social Security before their 65th birthday by going down to their local Social Security office, calling 1 (800) MEDICARE or by getting on the website at: medicare.gov and doing a live chat.
Some seniors delay entry into Medicare for various reasons. But once they jump onboard, Dodson said they’ll have to prove that they had what is called creditable coverage, or coverage that meets a minimum set of qualifications, from the age of 65 on. If seniors can’t provide the proof they need, they will have to pay a penalty every month for the rest of their lives.
“The one thing I want them to know about our plan is that it is creditable,” Dodson said of any concerns archdiocese employees may have. “So, if they join Medicare later and have to prove they had creditable coverage, our plan is creditable. They can stay on our plan until they are ready to go on Medicare.”
When that time comes, Dodson said, she and the HR department will provide all of the necessary forms and letters their employees need to prove their plan is creditable.
If that time is now, however, do your homework. The Dec. 7 deadline for open enrollment is fast approaching!
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